Ten Percent of Individuals with Prediabetes and Undiagnosed Diabetes Have Chronic Kidney Disease
That means it is worth screening for diabetes and prediabetes. Patients with stage 3 or greater chronic kidney disease (CKD), are very high risk and high cost. CKD identifies the patients with prediabetes and early diabetes who need more attention from your cardiometabolic team and should be on optimal medical therapy.
Chronic kidney disease is microvascular disease. Patients with chronic kidney disease (CKD) are likely to have microvascular disease of the heart as well. Microvascular disease involves the tiny arteries rather than the larger one. These patients have a cardiovascular mortality twenty times that of patients without that problem. In fact, patients with CKD are more likely to die of cardiovascular disease than progress to dialysis.
Uncomplicated prediabetes and undiagnosed diabetes are not as dangerous and those patients do not cost as much. It is worth screening for those conditions in people with extra abdominal fat so that you can then look for CKD with a simple blood and urine test. By making certain that these patients with CKD are on optimal medical therapy, you can keep them from dying or having a heart attack or stroke. You can reduce their cost of care. It is important to apply extra resource where they will do the most good.
Actually, most of pre diabetics have early signs of ischemia/cardiovascular disease, if tested on MCG. The early lifestyle optimization and OMT, if necessary, make a huge difference in deterring the onset of CKD. Early detection and primary prevention is the key to solving this problem.